Liver Biopsy: is it Safe in Children?

Introduction: The blind liver biopsy technique has been widely used in Sudan as the availability of the ultra sound machines and the committed Pediatrics Radiologist were not always at hands. Liver biopsy is an essential tool in the diagnosis of liver diseases and subsequently; initiating the appropriate treatment. Objective: The aim of the study was to observe the safety of blind liver biopsy in our children. retrospectively. Using a standard percussion technique biopsy sites were chosen and through intercostals space blind liver biopsies were performed by TruCut biopsy needle. The study was conducted at Gafaar Ibn Oaf Specialized Children Hospital; Khartoum Sudan; over the last five years; between January 2005-January 2010. Results: The first biopsy sample was considered macroscopically adequate in 94.8of cases. A years of age and of these 8 (11.4) complained of pain at the biopsy site; external hemorrhage from the biopsy site was seen in 1 (0.6) case but no sign of internal hemorrhage was detected during the 24 hours follow up period. No child died following the procedure. Conclusions: Blind liver biopsy in the studied hospitalized children was found to be a safe procedure

Pattern of Liver Diseases in Sudanese Children

We aimed at determining the pattern and the incidence of liver disease in the Sudanese children referred to the Gastroenterology unit as Gaafar Ibn Oaf Specialized Children Hospital; which has not been studied before. Materials and Methods: In a cross-sectional study conducted over 5 years; 450 liver needle biopsies were sent to the pathology laboratory of our center. Slides were prepared from paraffinembedded blocks; stained by routine H et E and special stains and were then reviewed. The frequency of each disorder; separately and in combination with the age group or gender of the patient were compared with other similar studies. Results: The male to female ratio was 1.5:1.The age range between 1 month and 15 years old and 42were less than 1 year old. The most common histological diagnosis was liver cirrhosis where no specific cause could be found (26) followed by neonatal hepatitis(20);fatty liver(12);Billary Atresia(10);chronic hepatitis(8); metabolic liver disease (6); Progressive Intrahepatic Cholestasis (5.5); non specific pathological changes (4.4) and Hepato Cellular Carcinoma in(4). Conclusion: A liver biopsy is a useful and practical tool for the appropriate diagnosis of pediatric liver diseases. We found that Idiopathic Liver Cirrhosis; Neonatal Hepatitis; Fatty Liver; Billary Atresia and Chronic Hepatitis in the stated order are the most prevalent histological diagnosis in Sudanese children. Hepatocellular Carcinoma is significantly high in our pediatrics population